<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('采购价')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-purchase" class="form-control" name="row[purchase]" type="text" value="{$row.purchase|htmlentities}">
        </div>
    </div>


    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('售药价')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sell" class="form-control" name="row[sell]" type="text" value="{$row.sell|htmlentities}">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('生产日期')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-production_time" class="form-control datetimepicker" name="row[production_time]" type="text" value="{$row.production_time|htmlentities}" autocomplete="off" data-date-use-current="false" data-date-format="YYYY-MM-DD">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('药品有效期')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-end_time" class="form-control datetimepicker" name="row[end_time]" type="text" value="{$row.end_time|htmlentities}" autocomplete="off" data-date-use-current="false" data-date-format="YYYY-MM-DD">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('类型')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select id="c-pids" data-rule="required" class="form-control selectpicker" name="row[type]">
                <option data-type="type" value="1">增加</option>
                <option data-type="type" value="2"  >减少</option>
            </select>
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('数量')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-count" class="form-control" name="row[count]" type="text" value="0">
        </div>
    </div>

    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
